Vertigo | |
---|---|
Drawing showing the sensation of vertigo | |
Pronunciation | |
Specialty | Otorhinolaryngology |
Symptoms | Feeling of spinning or swaying, vomiting, difficulty walking[1][2] |
Causes | Benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, stroke, brain tumors, brain injury, multiple sclerosis, migraine[1][2] |
Differential diagnosis | Presyncope, disequilibrium, non-specific dizziness[2] |
Frequency | 20–40% at some point[3] |
Vertigo is a condition in which a person has the sensation that they are moving, or that objects around them are moving, when they are not.[1] Often it feels like a spinning or swaying movement.[1][2] It may be associated with nausea, vomiting, perspiration, or difficulties walking.[2] It is typically worse when the head is moved.[2] Vertigo is the most common type of dizziness.[2]
The most common disorders that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and vestibular neuritis.[1][2] Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears.[2][4][5] Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed.[6][7] Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin.[8] Vertigo typically indicates a problem in a part of the vestibular system.[2] Other causes of dizziness include presyncope, disequilibrium, and non-specific dizziness.[2]
Benign paroxysmal positional vertigo is more likely in someone who gets repeated episodes of vertigo with movement and is otherwise normal between these episodes.[9] Benign vertigo episodes generally last less than one minute.[2] The Dix-Hallpike test typically produces a period of rapid eye movements known as nystagmus in this condition.[1] In Ménière's disease there is often ringing in the ears, hearing loss, and the attacks of vertigo last more than twenty minutes.[9] In vestibular neuritis the onset of vertigo is sudden, and the nystagmus occurs even when the person has not been moving.[9] In this condition vertigo can last for days.[2] More severe causes should also be considered,[9] especially if other problems such as weakness, headache, double vision, or numbness occur.[2]
Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo.[3] About 5% have vertigo in a given year.[10] It becomes more common with age and affects women two to three times more often than men.[10] Vertigo accounts for about 2–3% of emergency department visits in the developed world.[10]